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Writing a success story in Sierra Leone

What if one day we were able to write, “This is a success story: it’s a story about a wise policy maker who made the right decision, capable experts who planned the right actions, committed donors who granted the right support and stayed the course to translate policies into actions, and actions that ultimately brought about tangible and lasting results for mothers and children’s health. This is the story of Sierra Leone”.

I think that we are getting there! But let us rewind the story for a moment. Let’s take a step back to where we are standing now, with many challenges ahead, and a promise that is too important to allow it to fail.

Last week, the Sierra Leone Donor Conference (London, November 18-19, 2009) went very well: free health care for pregnant/lactating women and children under five was prominent in the government’s agenda, and donors committed support for its implementation. As part of the “Agenda for Change”, the President’s manifesto for development in Sierra Leone, the policy change that led to the announcement of the abolition of user fees, and the introduction of free health care as of April 27, 2010 (which is also Sierra Leone’s Independence day) was clearly articulated. The funding gap of US$20 million necessary to take the policy forward was clearly highlighted.

A film produced by the Government of Sierra Leone, in collaboration with Save the Children, which breaks the free health care strategy document into simple language and facts, told through the words and stories of Sierra Leoneans themselves, was showed. It was great to watch health priorities take central stage in the donor’s conference plenary. We watched Matea, a child living in Kailahun, and Amie, a state registered nurse in Freetown, telling us the steps, (“as easy as 1-2-3”), to make healthcare accessible to all those who need it, and to ultimately reduce the mortality rates. The film was followed by applause, expressing support for the steps taken by the Sierra Leonean government in this direction.

Knowledge of what it takes to abolish user fees and replace them with pro-poor financing mechanisms is available, and the government of Sierra Leone has used that knowledge to make a strategy that can be delivered. The political will to support free healthcare for mothers and children, both on the part of the Government of Sierra Leone and by key donors, was unequivocal. It’s a high priority for the health sector and ultimately a sensible intervention to improve health in the country.

The UK Government announced that £60 million is currently programmed for the Sierra Leonean Health Sector through 2012, part of which will be re-profiled to support free health care and the Health Sector Strategic Plan; it invited donors and development partners to join in bridging the current funding gap. Irish Aid announced 10 million Euros in support of the Agenda for Change through 2010, and qualified maternal and child health and nutrition as priorities. The World Bank communicated US$20 million for an up-coming Reproductive and Child Health Project and a willingness to support free health care.

The President, H.E. Ernest Bai Koroma, concluded the conference by highlighting the Sierra Leonean government’s clear vision: change, focus on the future, commitment to support change and partnerships as the way forward. We certainly agree all of these elements strongly apply to the case of free health care, and will be crucial to turn the abolition of user fees from vision into reality.

The conference outcome has given the green light to set the plan in motion. Now it’s time to materialize the financial and technical assistance needed to make it ready to deliver free healthcare at the point of access for mothers and children. We need to work hard to meet the deadline of April 27, 2010 so that we can write that success story.

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